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Workers' Compensation Coverage and Benefits

It is mandatory under the Pennsylvania Workers' Compensation and Occupational Disease Acts that an employer carry workers' compensation insurance. Failure to comply with these laws, subjects employers to lawsuits by employees and criminal prosecution which could result in substantial fines, imprisonment or both.

When Coverage Begins -- Employer

Coverage begins the day after we receive a properly completed workers' compensation application accompanied by the premium check.

When Coverage Begins -- Employee

Employees are covered for workers' compensation benefits the first day on the job.

What Does Workers' Compensation Insurance Cover

Workers' compensation insurance provides wage-loss and medical benefits to compensate employees who are injured, contract a disease or have a condition worsen as a result of employment, regardless of the employee's previous medical or physical condition and without regard to the employee's fault in most cases.

If you suffer from a work related injury, your employer or its insurance company must pay for reasonable and necessary medical expenses related to the injury.

What Medical Coverage Is Included Under The Policy

  1. Services rendered by physicians or other health care providers, including chiropractors.

  2. Reasonable surgical and medical services needed.

  3. Hospital treatment, services and supplies. Workers' compensation provides for semi-private rooms, or for private room accommodations if there are no semi-private rooms available. Costs for hospital treatment, services and supplies may not exceed the prevailing charges by the hospital for similar treatment, services and supplies provided to other patients.

  4. Prescription medicines and supplies.

  5. Orthopedic appliances and supplies.

What Workers' Compensation Insurance Does Not Cover

Workers' compensation insurance does not compensate for pain and suffering. It does not provide job security in the event of an injury. Workers' compensation insurance does not guarantee that certain contract benefits covered in a collective bargaining agreement will continue for the injured worker.

Benefits Under Workers' Compensation

If an injury or disease is found compensable, compensation benefits available to employees in Pennsylvania are:
  • Replacement Of Lost Wages. Approximately two-thirds of the workers' salary for total disability (up to a maximum dollar amount provided by law) is paid for the time lost from work as a result of the work related disability, if the disability lasts longer than seven calendar days. There is no maximum payment period. Payments are made for the duration of the disability. These payments are tax free.

  • Total disability benefits are paid for as long as an employee is unable to return to work as a result of a work related injury or disease. The employee is entitled to workers' compensation payments until:

    1. Medical recovery with no restrictions, established by an Agreement or a Workers' Compensation Judge's decision.

    2. Actual return to full, pre-injury employment.

    3. The employee is medically able to preform other employment which is currently available to the employee with no loss in earnings.